Job Description
Review & Processes Healthcare payer claims including HCFA & UB forms.
Validate Member, Provider and other Claims information.
Determine accurate payment criteria for clearing pending claims based on defined Policy and Procedure.
Coordination of Claim Benefits based on the Policy & Procedure.
Maintain productivity goals, quality standards and aging timeframes.
Scrutinizing Medical Claim Documents and settlements.
Organizing and completing tasks per assigned priorities.
Developing and maintaining a solid working knowledge of the healthcare insurance industry and of all products, services and processes performed by the tea
Resolving complex situations following pre-established guidelines
Requirements for this role include:
University degree or equivalent that required formal studies of the English language and basic Math
3+ Year of experience where you had to apply business rules to varying fact situations and make appropriate decisions
3+ Year...
Validate Member, Provider and other Claims information.
Determine accurate payment criteria for clearing pending claims based on defined Policy and Procedure.
Coordination of Claim Benefits based on the Policy & Procedure.
Maintain productivity goals, quality standards and aging timeframes.
Scrutinizing Medical Claim Documents and settlements.
Organizing and completing tasks per assigned priorities.
Developing and maintaining a solid working knowledge of the healthcare insurance industry and of all products, services and processes performed by the tea
Resolving complex situations following pre-established guidelines
Requirements for this role include:
University degree or equivalent that required formal studies of the English language and basic Math
3+ Year of experience where you had to apply business rules to varying fact situations and make appropriate decisions
3+ Year...
💡 Quick Summary
Seeking a career-building opportunity? The BPO HC Insurance Operations Senior Associate position is now open for candidates interested in the BPO Jobs sector. This role in Chennai offers a professional environment and growth potential.
Requirement Snapshot: Candidates should possess basic communication skills, a proactive attitude, and the ability to work in a team. Experience in BPO Jobs is a plus.